Effect of hypertension and its treatment on lipid, lipoprotein(a), fibrinogen, and bilirubin levels in patients referred for dyslipidemia

Abstract

We measured the serum lipid profile, together with plasma fibrinogen and serum lipoprotein(a) (Lp[a]), glucose, bilirubin, and albumin levels in 491 patients (310 men) who were referred for the management of primary dyslipidemia. All these variables have been shown to predict vascular events. The patients were not taking lipid-lowering drugs; hypertension was present in 156 (31.7%) of them. Of the hypertensive patients, 52 (33%) were not receiving any treatment to control their blood pressure. This omission was not due to a lower prevalence of established vascular disease. The treated hypertensives were divided into three groups according to their treatment: 62 were taking lipid-hostile antihypertensives (beta-blockers, thiazides), 37 were taking lipid-neutral antihypertensives (angiotensin converting enzyme inhibitors, Ca-channel blockers, angiotensin II receptor blockers, indapamide sustained release), and five were taking lipid-friendly antihypertensives (doxazosin). Lipid-hostile antihypertensive drugs were associated with a significantly higher fibrinogen concentration when compared with untreated hypertensives or those taking lipid-neutral/lipid-friendly drugs (median values: 383, 353, and 336 mg/dL, respectively; P < .01). Lipid-neutral/lipid-friendly antihypertensive drugs were associated with lower Lp(a) levels when compared with untreated hypertensives (median values: 22 and 45 mg/dL, respectively; P < .05). The serum bilirubin level was significantly lower in the untreated hypertensives when compared with normotensives or the treated hypertensives. There were no significant differences in lipids, glucose, or albumin among the groups of hypertensives or normotensives. The influence of antihypertensive drugs on additional cardiovascular risk factors should be considered when selecting medication to reduce blood pressure.

Effect of statins and ACE inhibitors alone and in combination on clinical outcome in patients with coronary heart disease

“…31,32 For example, ACEIs and statins can have beneficial effects on haemostatic and other factors. [33][34][35][36] Moreover, it has been shown that treatment with ACEIs 37,38 and statins 39,40 improved vasodilatation and decreased vascular damage. A significant additive effect on structural vascular damage, blood pressure, and vascular resistance was also shown during combination treatment of simvastatin and enalapril in hypertensive subjects.…”

Angiotensin II can induce and potentiate shape change in human platelets: effect of losartan

“…Other Ang II receptor blockers or antihypertensive drugs may not share the 'specific' TXA 2 -inhibiting property of losartan if their struc-ture does not include an imidazole group. The additional anti-thrombotic properties of antihypertensive drug [30][31][32][33][34][35] may influence prescribing habits. Platelet responses to Ang II may reflect the changes occurring in other tissues.…”

Diabetes, bilirubin and amputations: is there a link?

“…We have shown, in a small study, that bilirubin levels were lower in untreated hypertensive individuals compared with normotensive people or treated hypertensive patients. We attributed this effect to the antioxidant actions of certain drugs used to treat hypertension and to a higher level of oxidative stress in untreated hypertensive patients [10]. These studies suggest that commonly used drug treatments (i.e.…”